DR. MERYL PANKHURST (PSY.D.) – Clinical Psychologist, NPI 1407288079

DR. MERYL PANKHURST (PSY.D.) is a healthcare provider. based in Northfield, Illinois. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSY.D.. They hold a License No. 071004395 (IL). The NPI Number for DR. MERYL PANKHURST (PSY.D.) is 1407288079

Main info

Female
Sole Proprietor
17 Years Of Experience
Accepts Medicare Assignment
Name
DR. MERYL PANKHURST (PSY.D.)
NPI
1407288079
Phone
(847) 686-0090
Address
465 N CENTRAL AVE
Enumeration Date
6 August 2013
Last Update Date
6 August 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2009 (17 years ago)
PAC ID
6002187614
Group Practice PAC ID
1355732777
Professional Enrollment ID
I20170731003541
Address ID
IL606113800CH160XXAVEX402
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

1,600 CLINICAL PSYCHOLOGIST in IL

Provider Addresses for DR. MERYL PANKHURST (PSY.D.)

  • 465 N CENTRAL AVE

    SUITE 201

    NORTHFIELD, IL 600933015

    Phone: (847) 686-0090

    Fax: (847) 686-0090

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-07-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170731003541IClinical PsychologistILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60093)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355732777View full group profile
NameSpecialtyState
Clinical PsychologistIL
Clinical PsychologistMA
Clinical PsychologistMA
Clinical PsychologistIL
Clinical PsychologistIL
Clinical PsychologistIL
Clinical PsychologistIL
Clinical PsychologistIL

Reviews

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Frequently asked questions

What is DR. MERYL PANKHURST (PSY.D.)'s NPI number?
DR. MERYL PANKHURST (PSY.D.)'s NPI is 1407288079 — the number used across U.S. healthcare to identify this provider.
Is there an active status for DR. MERYL PANKHURST (PSY.D.)?
For scheduling context, DR. MERYL PANKHURST (PSY.D.) is shown as active in the registry.
What kind of doctor is DR. MERYL PANKHURST (PSY.D.)?
DR. MERYL PANKHURST (PSY.D.) is associated with Clinical Psychologist in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with DR. MERYL PANKHURST (PSY.D.)?
Directory geography for DR. MERYL PANKHURST (PSY.D.) centers on Northfield, Illinois.
Can I trust this NPI listing for DR. MERYL PANKHURST (PSY.D.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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